Premium
Rapid and Sustained Long‐Term Decrease of Fecal Short‐Chain Fatty Acids in Critically Ill Patients With Systemic Inflammatory Response Syndrome
Author(s) -
Yamada Tomoki,
Shimizu Kentaro,
Ogura Hiroshi,
Asahara Takashi,
Nomoto Koji,
Yamakawa Kazuma,
Hamasaki Toshimitsu,
Nakahori Yasutaka,
Ohnishi Mitsuo,
Kuwagata Yasuyuki,
Shimazu Takeshi
Publication year - 2015
Publication title -
journal of parenteral and enteral nutrition
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.935
H-Index - 98
eISSN - 1941-2444
pISSN - 0148-6071
DOI - 10.1177/0148607114529596
Subject(s) - systemic inflammatory response syndrome , feces , medicine , butyrate , gastroenterology , propionate , parenteral nutrition , intensive care unit , short bowel syndrome , multiple organ dysfunction syndrome , sepsis , microbiology and biotechnology , biology , fermentation , food science , biochemistry
Background : The gut is an important target organ for injury after severe insult. Short‐chain fatty acids (SCFAs) are end‐products of fermentation of dietary fibers by anaerobic microbiota. They are related to intestinal energy, motility, and transport and to protective effects against infection and inflammation. However, there are few clinical data on SCFAs in critically ill patients. We evaluated serial change in fecal SCFAs in patients with severe systemic inflammatory response syndrome (SIRS). Patients and Methods : This study included 140 intensive care unit (ICU) patients who fulfilled the criteria of SIRS and had a serum C‐reactive protein level of >10 mg/dL. A fecal sample was used for quantitative measurement of fecal SCFA (butyrate, propionate, and acetate) concentrations by high‐performance liquid chromatography. Fecal SCFAs were evaluated weekly for 6 weeks after admission. Data obtained from patients were compared with corresponding data from healthy volunteers. Results : SIRS resulted from infection in 78 patients, trauma in 30, burns in 12, and other causes in 20. Fecal concentrations of butyrate, propionate, and acetate in these patients decreased significantly compared with those in healthy volunteers and remained low throughout the 6 weeks of the patients' ICU stay. Fecal concentrations of SCFAs in the patients with gastrointestinal complications, including enteritis and dysmotility, were lower than those in the patients without gastrointestinal complications. Conclusions : Concentrations of fecal SCFAs in patients with severe SIRS were significantly lower than those in healthy volunteers over a 6‐week period. Maintenance of SCFAs may have therapeutic potential to prevent gastrointestinal complications in critically ill patients.